Influence of Sociodemographic and Psychosocial Factors on Length of Stay After Surgical Management of Traumatic Spine Fracture with Spinal Cord Injury

Hagan, Matthew; Pertsch, Nathan J.; Leary, Owen P.; Sastry, Rahul; Ganga, Arjun; Xi, Kevin; Zheng, Bryan; Kondamuri, Nikash S.; Camara-Quintana, Joaquin; Niu, Tianyi; Sullivan, Patricia Zadnik; Abinader, Jose Fernandez; Telfeian, Albert E.; Gokaslan, Ziya L.; Oyelese, Adetokunbo A.; Fridley, Jared

doi:10.1016/j.wneu.2022.07.128

Cited by 4 publications

(4 citation statements)

References 45 publications

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“…similarly found that increasing ISS was an independent predictor or discharge to a rehabilitation facility following hospitalization for spinal cord injury (p<0.002) [41] . This finding is also complemented by our group's recent work which found that high ISS and low GCS scores were associated with longer lengths of stay, suggesting more severe injury and need for rehabilitation post-hospitalization [42] .…”

Section: Discussionsupporting

confidence: 59%

Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States

Hagan

Pertsch

Leary

et al. 2022

North American Spine Society Journal (NASSJ)

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Section: Discussionsupporting

confidence: 59%

Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States

Hagan

Pertsch

Leary

et al. 2022

North American Spine Society Journal (NASSJ)

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“…The variability in outcomes observed across the studies underscores the need for context-specific considerations in prehospital SCI management. Factors such as the mechanism of injury, type of trauma, and patient demographics may influence the effectiveness of interventions [21]. These nuances align with existing literature highlighting the heterogeneous nature of spinal cord injuries and the importance of tailored approaches based on the intricacies of each case.…”

Section: Resultsmentioning

confidence: 52%

Prehospital Emergency Interventions for Idiopathic Spinal Cord Injury Prevention

Alhurtumi,

Aloufi,

Alharbi

et al. 2023

IJSR

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Introduction: Despite the critical role of prehospital management, variations persist in global practices. Recent literature indicates that about 35% of emergency medical services (EMS) providers adhere to established guidelines for spinal immobilization in certain regions. This systematic review aimed to contribute to the ongoing dialogue surrounding the prehospital management of SCIs, ultimately improving outcomes for individuals affected by these traumatic injuries. Methods: A comprehensive literature review was conducted through a systematic search of electronic databases, employing refined search terms and Boolean operators to focus on prehospital management of spinal cord injuries from the inception of each database to July 2023. Inclusion criteria involved original research articles, systematic reviews, and meta-analyses, with a screening process led by two independent reviewers and subsequent data extraction to inform evidence synthesis, accounting for study limitations and bias assessments. Results: This systematic review summarizes findings from eight clinical interventional studies on preventing idiopathic spinal cord injury (SCI) during prehospital emergency aid for traumatized patients. The studies encompassed diverse populations and interventions, revealing variable effectiveness in reducing idiopathic SCI incidence. Notably, specialized protocols for pediatric spinal immobilization and modifications for geriatric patients demonstrated promising effectiveness, emphasizing the importance of age-specific considerations in prehospital care for SCI prevention. Conclusions: The systematic review findings underscore the nuanced nature of prehospital interventions for idiopathic spinal cord injury prevention, emphasizing the importance of age-specific considerations and cautioning against a one-size-fits-all approach, while also highlighting the need for ongoing research to refine protocols and improve patient outcomes given the lack of definitive evidence in favor of early versus delayed immobilization.

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“…11,13,27,28 Mechanism of injury, including traffic accidents, impairment level, alcohol use disorder, and hospital complications, including urinary tract infections, have all been linked to increased hospital LOS. 29,30 These various factors are present among the present study's patients with prolonged LOSs.…”

Section: Discussionmentioning

confidence: 74%

“…When looking at cases of nonpenetrating and penetrating SCIs, Avila et al 25 found the average LOSs was 15 days (0–316) and 23 days (0–305), respectively, for ICU and hospital LOS. Finally, Hagan et al 26 reported that the average LOS for patients with cervical spine fractures with SCIs was 10 days. Other studies, some outside the United States, have found the hospital LOS ranging between 17.9 and 56 days 17,27 .…”

Section: Discussionmentioning

confidence: 99%

Hospital Course and Complications of Subaxial Cervical Trauma Patients With Tetraplegia or Paraplegia

Scott,

Patel,

Lucasti

et al. 2023

Clinical Spine Surgery

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Study Design: A single-institution, retrospective cohort study Objective: The objective was to present demographic characteristics, mechanism of injuries, lengths of stay, intensive care unit (ICU) days, discharge locations, and causes of 90-day readmission for patients with subaxial spinal cord injuries resulting in paraplegia or tetraplegia. Summary of Background Data: Spinal cord injuries resulting in paraplegia or tetraplegia are rare injuries with debilitating outcomes. Numerous advances have occurred in caring for these patients, but patients still experience multiple complications. The severity of these injuries and numerous complications result in prolonged hospital stays and the need for extensive rehabilitation. Methods: Twelve patients with subaxial spinal cord injury resulting in paraplegia or tetraplegia from a level 1 adult trauma center were reviewed. The primary outcomes included hospital length of stay, ICU days, intrahospital complications, 90-day readmission rates, and discharge location. We reviewed the literature for these outcomes in spinal cord injuries. Results: For patients with subaxial spinal cord injuries resulting in paraplegia and tetraplegia, the average age was 36.0 years, and most were male [91.7% (11/12)]. The most common mechanism of injury was gunshot wounds[41.7% (5/12)]. Patients spent an average of 46.3 days in the hospital and 30.7 days in the ICU. Respiratory complications were the most common (9 patients). Fifty percent of patients (6/12) were discharged to the inpatient spinal cord rehab center, and 16.7% (2/12) expired while in the hospital. Two patients (20.0%) were readmitted within 90 days of discharge. Conclusions: Most patients with subaxial spinal cord injuries resulting in paraplegia or tetraplegia were young males with high-energy traumas. Many patients had intrahospital complications, and most were discharged to the hospital spinal rehab center. These findings likely stem from the severity of paraplegia and tetraplegia injuries and the need for rehabilitation.

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Influence of Sociodemographic and Psychosocial Factors on Length of Stay After Surgical Management of Traumatic Spine Fracture with Spinal Cord Injury

Cited by 4 publications

References 45 publications

Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States

Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States

Prehospital Emergency Interventions for Idiopathic Spinal Cord Injury Prevention

Hospital Course and Complications of Subaxial Cervical Trauma Patients With Tetraplegia or Paraplegia

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